scholarly journals Ruptured left ventricular subvalvar mitral aneurysm into the left atrium and left ventricle to left atrium fistula: case report of two pathological entities

2021 ◽  
pp. 45-47
Author(s):  
JL Esterhuizen ◽  
MA Long ◽  
EW Turton
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Ventricular ◽  
Rare Entity ◽  
Shortness Of Breath ◽  
Atypical Chest Pain ◽  
Aneurysm Neck ◽  
Valve Annulus

Subvalvar mitral aneurysm is a rare entity that mostly occurs in the African population. We present a case of a 23-year-old male patient who presented with shortness of breath and atypical chest pain. On preoperative transthoracic echocardiography, a subvalvar mitral aneurysm was noted with severe regurgitation from the aneurysm opening into the left atrium. The surgical findings revealed a single aneurysm neck present in the posterior mitral valve annulus. In addition to and separate from the aneurysm, a left ventricular to left atrial fistula was present.

scholarly journals Cerebral embolism due to left atrial myxoma in a patient presenting with chest pain and ST-segment elevation: a case report

2020 ◽  
Author(s):  
António Fontes ◽  
Nuno Dias-Ferreira ◽  
Anabela Tavares ◽  
Fátima Neves
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Left Atrial ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Left Atrial Myxoma ◽  
St Segment ◽  
Wide Range ◽  
St Elevation

Abstract Background Myocarditis is an uncommon, potentially life-threatening disease that presents with a wide range of symptoms. In acute myocarditis, chest pain (CP) may mimic typical angina and also be associated with electrocardiographic changes, including an elevation of the ST-segment. A large percentage (20–56%) of myxomas are found incidentally. Case summary A 62-year-old female presenting with sudden onset CP and infero-lateral ST-elevation in the electrocardiogram. The diagnosis of ST-elevation myocardial infarction was presumed and administered tenecteplase. The patient was immediately transported to a percutaneous coronary intervention centre. She complained of intermittent diplopia during transport and referred constitutional symptoms for the past 2 weeks. Coronary angiography showed normal arteries. The echocardiogram revealed moderate to severe left ventricular systolic dysfunction due to large areas of akinesia sparing most of the basal segments, and a mobile mass inside the left atrium attached to the septum. The cardiac magnetic resonance (CMR) suggested the diagnosis of myocarditis with concomitant left atrial myxoma. The patient underwent resection of the myxoma. Neurological evaluation was performed due to mild vertigo while walking and diplopia in extreme eye movements. The head magnetic resonance imaging identified multiple infracentimetric lesions throughout the cerebral parenchyma compatible with an embolization process caused by fragments of the tumour. Discussion Myocarditis can have various presentations may mimic acute myocardial infarction and CMR is critical to establish the diagnosis. Myxoma with embolic complications requires emergent surgery. To the best of our knowledge, this is the first case reported in the applicable literature of a myxoma diagnosed during a myocarditis episode.

scholarly journals 1112 Discovering the origin of a mysterious heart cavity

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
V Vidal Urrutia ◽  
P Garcia Gonzalez ◽  
J L Perez Bosca ◽  
D Escribano Alarcon ◽  
J M Simon Machi ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Contrast Echocardiography ◽  
Left Ventricular ◽  
Atrial Appendage ◽  
Invasive Approach ◽  
Cardiovascular Morbidity And Mortality ◽  
Doppler Color

Abstract Left atrial appendage aneurysm is an infrequent cardiac malformation, with less than 150 cases reported in the literature. It is a congenital anomaly in the majority of cases, related to a dysplasia of pectinate muscles and atrial muscle bands, which tends to grow with age. At the present time, and despite of being not considered in current guidelines, surgical resection is the standard of treatment in the current literature, even in asymptomatic cases, based on cardiovascular morbidity and mortality by predisposing to atrial tachyarrhythmia, thromboembolism, and other rare conditions as coronary or left ventricular compression and rupture of the aneurysm. We report the case of a 53-year-old male patient presenting an episode of supraventricular paroxysmal tachycardia with the casual finding of a mysterious cavity in the transthoracic echocardiography. We found out the presence of a 50 mm cavity adjacent to the left atrium and left ventricle, with a bidirectional blood flow between the left atrium and the cavity when applying Doppler color and with contrast echocardiography. Given this finding, several differential diagnosis had to be considered, including vascular and structural disorders. In order to clarify the diagnosis, a cardiac magnetic resonance was performed. It revealed the presence of a huge aneurysm of the left atrial appendage (50 x 53 mm) causing a mild compression of the left ventricle, with no thrombus and no other significant findings. Due to its size, the compression of the left ventricle and the history of atrial arrhythmia we decided to manage it with an invasive approach by performing a middle thoracotomy, in order to prevent potentially serious complications. Abstract 1112 Figure. CMR 3D reconstruction; echocardiography

scholarly journals Left main coronary angioplasty – A case report

2009 ◽  
Vol 5 (1) ◽  
pp. 40-41
Author(s):  
SM Mustafa Zaman ◽  
Masud Sinha ◽  
Prodip Kumar Karmakar ◽  
Sufia Rahman ◽  
Md Harisul Hoque ◽  
...  
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Rare Case ◽  
Shortness Of Breath ◽  
Coronary Angiogram ◽  
Class Iii ◽  
Left Main ◽  
Left Main Disease ◽  
Vessel Disease ◽  
Triple Vessel Disease

A 52 years lady presented with chest pain and shortness of breath. Chest pain was initially CCS class II and gradually CCS class III. Coronary angiogram reveals triple vessel disease for which she underwent CABG (RSVG to LAD) in December 1999. On January 2003 PTCA with stent (sirolimus - 3 x 15m m) to LCX was done. She again complaints of chest pain after a short symptom less period. Recent coronary angiogram revealed TVD with left main involvement. In this article we will describe a rare case of successful stenting in left main disease.   doi: 10.3329/uhj.v5i1.3441 University Heart Journal Vol. 5, No. 1, January 2009 40-41

P4379Pathophysiology of left atrial filling in mitral regurgitation. A new volumetric flow rate index describing disturbed left atrial filling behavior in mitral regurgitation by 3D TTE

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Frumkin ◽  
K Stangl ◽  
A Muegge ◽  
T Buck ◽  
B Plicht
Keyword(s):  
Mitral Regurgitation ◽  
Left Atrium ◽  
Flow Rate ◽  
Left Atrial ◽  
Volume Overload ◽  
Volumetric Flow Rate ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Mean Flow ◽  
Flow Rates

Abstract Background In chronic mitral regurgitation (MR) the left atrium (LA) is one of the first cardiac structures involved in remodeling by progressive volume overload. Real-time three-dimensional echocardiography is able to monitor volumetric changes of the left atrium during the heart cycle. Purpose We hypothesized that chronic volume overload due to MR leads to detectable changes in the LA filling behavior described by mean and maximum filling flow rates and their relation called volumetric flow rate index. Methods We prospectively analyzed data of 36 patients in different stages of chronic MR and 13 patients without MR. Transthoracic echocardiography was conducted using the Epiq 7G Ultrasound System. Standard 2D- and 3D apical 4-chamber views were recorded and stored for offline analysis. We generated volume-time-curves by 3D volume analysis to derive mean and maximum volumetric flow rates during LA reservoir, conduit and pump phase. Volumetric flow rate index was calculated as the quotient of mean flow rate/maximum flow rate. Results Average MR severity, calculated with the MR Scoring system introduced from Buck et al. and implicated in the ESC Guidelines, was 6.2 points (±2.5) according to Grade I-II. We included 13 patients without MR, 18 with mild MR, 12 patients with moderate MR, 6 patients with severe MR. Left ventricular ejection fraction was similar in the different groups (51,2±12,3%). Maximum and mean flow rate showed no significant correlation with MR severity. Correlation of MR severity with LA dilation (ml/m2 BSA) was r=0.41; p<0.001. Flow rate index showed strong significant correlation with MR severity in left atrial reservoir phase (r=−0.75; p<0.001). There was no statistically relevant difference of volumetric flow rate parameters in left atrial pump and conduit phase. Line chart Conclusions We observed a significant correlation of the volumetric flow rate index to MR severity in the left atrial reservoir phase with stronger correlation than MR severity to left atrial dilation. The results of this work encourage further investigations to establish the presented volumetric flow rate index as a progression marker of MR and to evaluate its prognostic value.

Congenital total absence of the pericardium: A case report

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 315-317
Author(s):  
Arezou Zoroufian ◽  
Shapour Shirani ◽  
Behareh Eslami ◽  
Mohammad Sahebjam
Keyword(s):  
Physical Activity ◽  
Case Report ◽  
Chest Pain ◽  
Congenital Heart ◽  
Axial Tomography ◽  
Atypical Chest Pain ◽  
Total Absence ◽  
History Of ◽  
Computerized Axial Tomography ◽  
Tomography Scan

AbstractWe report the case of a 52-year-old woman who presented with a several-year history of palpitation (exacerbated by emotional stress and physical activity) and recent development of atypical chest pain. An investigation was undertaken to diagnose the patient’s problem and to recommend the best possible therapy. Transthoracic echocardiography and a computerized axial tomography scan showed evidence of complete absence of the pericardium, which is a rare congenital heart defect.

Prognostic value of CT-derived left atrial and left ventricular measures in patients with acute chest pain

2017 ◽  
Vol 86 ◽  
pp. 163-168 ◽  
Author(s):  
Richard A.P. Takx ◽  
Rozemarijn Vliegenthart ◽  
U. Joseph Schoepf ◽  
John W. Nance ◽  
Fabian Bamberg ◽  
...  
Keyword(s):  
Chest Pain ◽  
Left Atrial ◽  
Prognostic Value ◽  
Acute Chest Pain ◽  
Left Ventricular

Left Ventricular Fibroma Causing Atypical Chest Pain

2003 ◽  
Vol 11 (3) ◽  
pp. 258-260 ◽  
Author(s):  
Mukesh Goel ◽  
Rajneesh Malhotra ◽  
Vijay Kohli ◽  
Manisha Mishra ◽  
Sudhir Jain ◽  
...  
Keyword(s):  
Chest Pain ◽  
Left Ventricle ◽  
Left Ventricular ◽  
Atypical Chest Pain ◽  
Exertional Angina

A 29-year-old man with atypical chest pain for 3 years and exertional angina for 3 months was found to have a large homogenous mass in the apicolateral area of the left ventricle. The mass, weighing 78 g, was excised successfully and identified as a fibroma.

scholarly journals Decitabine Induced Transient Cardiomyopathy: A Case Report

2012 ◽  
Vol 6 ◽  
pp. CMO.S8598 ◽  
Author(s):  
Chitradeep De ◽  
Jaya Phookan ◽  
Valay Parikh ◽  
Tarun Nagrani ◽  
Mayur Lakhani ◽  
...  
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Troponin I ◽  
Acute Myocarditis ◽  
Coronary Vessels ◽  
Left Ventricular ◽  
Ventricular Rate ◽  
Heart Catheterization ◽  
Exertional Dyspnea ◽  
Coronary Syndrome

Case Report A 75-yr-old gentleman, with a past medical history of diabetes mellitus and Acute Myeloid Leukemia presented to our emergency department with a chief complaint of exertional dyspnea and chest pain. A week prior to this visit, he had recieved a cycle of decitabine chemotherapy at 20 mg/metered square for ten days. This was his second cycle of decitabine. His out patient medications included megesterol, omeprazole, morphine sulfate and insulin glargine. The patient was admitted to the Coronary Care Unit for Acute Coronary Syndrome. His cardiac enzymes were elevated (peak troponin 30 ng/mL, CKMB 67.4 ng/mL). His 12 lead EKG revealed sinus tachycardia with a ventricular rate of 113, but without acute ST–T wave changes. The BNP was 259 pg/mL. A 2D echo revealed moderate diffuse hypokinesis with an EF of 35%. He subsequently underwent a left heart catheterization, which showed non-obstructive CAD. In our patient, the elevated troponins (peak troponin 30 ng/mL) and BNP were seen concomitant with the onset of cardiogenic shock. Two months ago, his 2 D echocardiogram revealed an ejection fraction of about 55%–65% with slightly increased left ventricular (LV) wall thickness. Discussion The most common adverse effects of decitabine include cytopenia, nausea, pain and erythema/nodules at the injection site. To date, there has been only one reported case of a hypomethylating agent inducing acute myocarditis. We a present a case of reversible, non-ischemic cardiomyopathy secondary to decitabine chemotherapy, which resolved after the drug was discontinued. Trials involving decitabine for the treatment of MDS reported no myocarditis. In our case, the diagnosis of transient cardiomyopathy was highly probable since the patient's troponins and echocardiogram returned to baseline after discontinuation of treatment. Also, the patient never had any further chest pain at his 6 month follow up. In this case, we believe that the elevated Troponin I levels, along with a cardiac catheterization revealing patent coronary vessels, favor our hypothesis that our patient suffered from acute myocarditis as a result of direct toxicity from decitabine chemotherapy. We doubt that there was an underlying infectious etiology, since the patient had three negative blood cultures, two negative urine cultures and a negative viral serology. Our case demonstrates that chest pains in a patient treated with hypomethylating agents should be further explored in order to rule out acute myocarditis.

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